New clinical problems have emerged for patients with thalassemia as their life span has been increased by improved transfusion therapy and the regular use of the iron chelating agent deferoxamine. Foremost among these problems is osteoporosis and an increased incidence of fractures. Numerous factors, including delayed puberty, parathyroid disease and sex hormone deficiencies, contribute to the high incidence of osteoporosis. The present study has been designed to assess bone mineral density on a longitudinal basis as part of an ongoing comprehensive evaluation of endocrine disturbances in patients with thalassemia. In the first six months of study, 20 patients with thalassemia, ranging in age from 10 to 47 years, have undergone at least one DEXAscan of the whole body, spine, hips and forearm. At the time of measurement of bone density, the patients have also undergone anthropometric examination with measurement of weight as well as sitting and standing height. Patients enrolled in the study also undergo annual comprehensive endocrinologic examination as well as assessment of the severity of iron overload. These data should lead to a characterization of the gender-based and age-related frequency of osteoporosis in thalassemia, and a correlation of presence or absence of osteoporosis with other factors such as iron status, parathyroid insufficiency and vitamin D levels.